Upper Limb: Hand Region Flashcards
Which of the following is considered a function of the hand? Select all that apply.
Grasp and manipulation of objects
Expression through gestures
Sexual functions
Orienting objects in space
Grasp and manipulation of objects
Expression through gestures
Sexual functions
True or false: The ability of the hand to conform to the characteristics of object surfaces is called accommodation.
True
True or false: Drinking from a water bottle requires use of a precision grasp whole holding a pen requires the use of a power grasp.
FALSE
It’s the opposite!
The CM joint of the thumb is formed by the articulation of the base of the 1st metacarpal bone with the __________.
A. Lunate
B. Pisiform
C. Trapezoid
D. TRapezium
D
True or false: The CM joint of the thumb is a saddle joint that allows for 3 degrees of freedom: flexion/extension, abduction/adduction, opposition/reposition.
True
Which of the following joints is formed by the articulation of the head of the metacarpal bones with the bases of the proximal phalanges?
A. Metacarpophalangeal joints
B. Interphalangeal joints
C. Carpometacarpal joints
A
Which ligament becomes taut when the MP joints are in flexion, limiting the abduction of the joints?
A. Palmar ligaments
B. Collateral ligaments
C. Transverse metacarpal ligaments
B
Which of the following structures forms the roof of the carpal tunnel?
A. Transverse carpal ligament
B. Extensor retinaculum
C. Palmar carpal ligament
D. Palmar aponeurosis
A
True or false: The tendons of FPL, FDS, FDP are contained in flexor tendon sheaths that consist of both a synovial layer and fibrous layer.
True
True or false: An infection in the tendon sheath of the thumb often presents with redness and swelling at the wrist because of the continuity of the ulnar bursa.
FALSE
The digital synovium of the little finger is a direct continuation of the common flexor synovial tendon sheath (ulnar bursa). It is the radial bursa that continues as the synovial sheath of the thumb and because of this continuation, and infection of the tendon sheath of the thumb presents at the wrist.
True or false: The function of the fibrous layer of the flexor tendon sheaths is to prevent bowstringing of the tendons as they cross multiple joints.
True
Which of the following structures of the extensor expansion is important for producing PIP extension?
A. Central band
B. Lateral band
C. Terminal band
A
Which of the following muscles is considered a muscle of the thenar muscle group? Select all that apply.
Opponens pollicis
Opponents digit minimi
Lumbricals
Flexor pollicis brevis
Adductor pollicis
Opponens pollicis
Flexor pollicis brevis
Adductor pollicis
Which of the following muscles originates from both the trapezium and the scaphoid? Select all that apply.
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Adductor pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Which of the following inserts onto the first metacarpal bone?
Opponens pollicis
Abductor pollicis brevis
Flexor pollicis brevis
Adductor pollicis
Opponens pollicis
Which of the following muscles originates from the pisiform?
Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi
Abductor digiti minimi
Which of the following muscles inserts on the 5th metacarpal?
Opponens digiti minimi
Abductor digiti minimi
Flexor digiti minimi brevis
Opponens digiti minimi
Which of the following muscles insert on the extensor expansion? Select all that apply.
Lumbricals
Dorsal interossei
Palmar interossei
Flexor pollicis brevis
Lumbricals
Dorsal interossei
Palmar interossei
Which carpal bones can be palpated in the anatomical snuff box?
Scaphoid and trapezium
Which palmar crease separates the thenar eminence from the central palm?
Radial longitudinal
What articulation forms the carpometacarpal joint of the thumb?
Trapezium with the first metacarpal of the first digit
What are the functions of the retinaculum that cross the volar and dorsal surfaces of the wrist?
Flexor retinaculum/Transverse carpal ligament: roof of carpal tunnel; contains FDS, FDP, FPL and median nerve
Extensor retinaculum: dorsal compartments
Which flexor tendons are contained in the ulnar bursa?
FDS and FDP
Which ligaments form the flexor pulley system?
Annular (4, sometimes 5) and cruciate (3)
What is the functional significance of the tendinous intersections of the ED over the dorsum of the hand?
Limits independent extension of the digits
What forms the central band of the extensor expansion?
Formed by the extensor digitorum tendon inserting into the base of the middle phalanx
It is important for extension of the PIP joint
The triangular tendinous aponeurosis that wraps around the dorsum and sides of the MP joint is called the _______________.
Extensor expansion
The synovial sheath of the flexor pulley system contains…
- Radial bursa: FPL
- Common flexor sheath (ulnar bursa): FDS and FDP tendons
- Digital sheaths
The fibrous sheath of the flexor pulley system contains…
Crucial and annular ligaments
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Opponens pollicis
Group: thenar (intrinsic)
Origin: flexor retinaculum; tubercle of trapezium
Insertion: lateral side of first metacarpal
Innervation: recurrent branch of median nerve
Action: rotates first metacarpal to oppose the thumb
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Abductor pollicis brevis
Group: thenar (intrinsic)
Origin: flexor retinaculum; tubercles of scaphoid and trapezium
Insertion: lateral side of base of proximal phalanx of thumb
Innervation: recurrent branch of median nerve
Action: abducts thumb; assists with opposition
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Flexor pollicis brevis
Group: thenar (intrinsic)
Origin: superficial head—flexor retinaculum and tubercle of trapezium; deep head—tubercle of scaphoid
Insertion: lateral side of base of proximal phalanx of thumb
Innervation: lateral half—recurrent branch of median nerve; medial half deep branch of ulnar nerve
Action: flexes thumb
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Adductor pollicis
Group: thenar (intrinsic)
Origin: oblique head—trapezoid, capitate, and bases of 2nd and 3rd metacarpals; transverse head—shaft of 3rd metacarpal
Insertion: medial side of base of proximal phalanx of thumb
Innervation: deep branch of ulnar nerve
Action: adducts thumb
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Opponens digiti minimi
Group: Hypothenar (intrinsic)
Origin: flexor retinaculum and hook of hamate
Insertion: palmar surface of 5th metacarpal
Innervation: deep branch of ulnar nerve
Action: rotates 5th metacarpal drawing it toward thumb in opposition
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Abductor digiti minimi
Group: hypothenar (intrinsic)
Origin: flexor retinaculum and pisiform
Insertion: medial side of base of proximal phalanx of pinky
Innervation: deep branch of ulnar nerve
Action: abducts the 5th digit; assists with flexion of 5th digit
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Flexor digiti minimi
Group: Hypothenar (intrinsic)
Origin: flexor retinaculum and hook of hamate
Insertion: medial side of base of proximal phalanx of pinky
Innervation: deep branch of ulnar nerve
Action: flexes proximal phalanx of pinky
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Lumbricals
Group: Short muscles of the hand (intrinsic)
Origin: 1 & 2—lateral 2 tendons of FDP as unipennate muscles; 3 & 4—medial 3 tendons of FDP as biennale muscles
Insertion: 1 & 2—lateral sides of extensor expansions of digit 2 and 3; 3 & 4—lateral sides of extensor expansions of digit 3 and 4
Innervation: 1 & 2—median nerve; 3 & 4—deep branch of ulnar nerve
Action: flexes MP joints and extends IP joints of digits: 1 & 2—2 and 3; 3 & 4—4 and 5
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Dorsal interossei
Group: Short muscles of the hand (intrinsic)
Origin: adjacent sides of two metacarpal bones (biennale muscles)
Insertion: extensor expansions and bases of proximal phalanges of digits 2-4
Innervation: deep branch of ulnar nerve
Action: abducts the MP joints of digits 2-4 and assists lumbricals with flexion of MP joints and extension of IP joints via extensor expansions
What muscle is this? Name its group, origin, insertion, innervation, and action.
Name: Palmar interossei
Group: Short muscles of the hand (intrinsic)
Origin: palmar surfaces of metacarpals of digits 2, 4, and 5 (unipennate muscles)
Insertion: extensor expansions and bases of proximal phalanges of digits 2, 4, and 5
Innervation: deep branch of ulnar nerve
Action: abducts the MP joints of digits 2, 4, and 5, and assists lumbricals with flexion of MP joints and extension of IP joints via extensor expansions
What body structure to the thenar muscles act on?
Thumb
What body structure to the hypothenar muscles act on?
Pinky
What body structure to the short muscles of the hand act on?
Digits
The intrinsic plus hand is characterized by ___________, __________, and _________. What is it caused by?
MP flexion, PIP extension, DIP extension
Imbalances between strong (or short) intrinsic and weak extrinsic muscles of the hand
The intrinsic minus hand is characterized by ___________, __________, and _________. What is it caused by?
MP extension, PIP flexion, DIP flexion
Imbalances between strong (or short) extrinsic and weak intrinsic muscles of the hand
Which carpal bone serves as an origin point for a majority of the thenar muscles?
Scaphoid and trapezium
Which carpal bone serves as an origin point for a majority of the hypothenar muscles?
Hamate (hook of hamate) - FDMB, ADM
What are the main actions of the lumbricals?
Flex MP joints and extend DIP and PIP joints
What muscles produce abduction at the MP joint?
Dorsal interossei
True or false: Carpal tunnel can cause loss of sensation to the palmar and anterolateral aspects of the hand.
False
The palmar cutaneous branch of the median nerve does not go through the carpal tunnel, so palmar sensation is kept in tact.
